Since the Better Access to Mental Health Care scheme began in 2006, there has been a great deal of confusion in the public about who can provide therapy and mental health services. Making an educated choice about who you would like to be your therapist has consequently become even more complex.
Being in therapy is a brave, vulnerable and courageous act. You need to be able to be appropriately met and supported when you decide to enter into it.
There are many modalities available, and this causes part of the confusion regarding how to choose your therapist. While all the different modalities show results, the main healing ingredient in therapy is the RELATIONSHIP.
The Better Access to Mental Health Care (BAMHC) scheme will provide you with 10 sessions per calendar year with a psychologist, mental health social worker and some mental health nurses, when you get a referral from your GP. While this can be great help for some, it can mislead others about therapy. More often than not 10 sessions are not enough for deep change. There is also no guarantee to be able to develop a good therapeutic relationship with the person you have been referred to. Your referral is also recorded in your file and the information can be requested by, for example, employers and insurance companies.
There are also the issues of education, and the services that can be provided under the BAMHC. In Australia, the main modality being taught in Universities for future psychologist and social workers is an evidence based therapy called Cognitive Behavioral Therapy (CBT). As a result, CBT has, sadly in my opinion, achieved a near monopoly in field of mental health care .
The evidence base of CBT comes from randomised controlled trials
. In these trials the only ingredient that cannot be controlled is the RELATIONSHIP. In the universities and private colleges that deliver the degrees in psychology and social work required for future BAMHC providers, students do not learn long term, in-depth psychotherapy that would help in developing RELATIONSHIPS with clients and patients.
There are couple of other modalities that can be provided by GP referred therapists offering the Medicare rebate, like some mindfulness based interventions and EMDR. However, if you are interested in other methods like somatic based-, psychodynamic psychotherapy, IPNB, Brainspotting, creative arts therapies and many others you are not able to use the BAMHC.
There are many great psychologists and social workers out there with many years of education (other than their basic university degree) who have a great capacity for building relationships, an aspect of treatment that we know is vital. You can find a directory of some of these practitioners here: Psychologists, Social Workers. I would suggest to do your research about their education, experience and their experience in therapy themselves.
Personally I did not pursue my clinical psychology degree because in a university lecture, in front of a room full of prospective psychologists, the professor jokingly said: ‘Some people say a psychologist should have their own therapy as well, how ridiculous!”. Almost everyone was laughing….
That attitude did not fit in with my integrity, so I become a Psychotherapist and a trauma expert.
Other options than using the BAMHC:
Psychotherapists are professionals who have training in long term, in-depth psychology, and psychotherapy. The methods that they use can be varied; somatic based, psycho-dynamic, Jungian, mindfulness based and so on. They can specialise in different mental health issues and life challenges.
Usually their education has a post-graduate component of 3+ years of psychotherapy training and they are required to have their own therapy as part of the training or as part of registration with their governing professional body. The training has a practical and experiential component of working with clients regularly, weekly or twice weekly basis for long term. The training focuses on how to develop a RELATIONSHIP.
Psychotherapists charge, generally between $100-$180 per 50 minutes and often work on a sliding scale or have discounted places for people who have genuine financially difficulties. I charge $165/50 minutes and have 4 places a week that I offer people for discounted rate.
You do not need a referral from your GP to see a psychotherapist and therefore your mental health history will be not available for employers or insurance companies. Some private health insurance companies provide some rebate for therapy.
Some psychologist, social workers and mental health nurses also trained and offer psychotherapy.
Counsellors are professionals who have at least a 3 years degree in counselling or applied psychology. Counselling is usually offered for as a short term solution-focused treatment. Counsellors generally are experimentally trained and do learn skills to develop the therapeutic relationship and are often encouraged to have their own therapy. They charge similarly to psychotherapists. and often can be found on the same directories: Pacfa, Australia Counselling, ACA.
Psychiatrists are doctors who have specialised training in psychiatry. Some psychiatrist provide long term psychotherapy treatment. You can get a referral from a GP or approach a psychiatrist/psychotherapist privately. The fees are varied and there are some Medicare rebates and also the Medicare Safety Net can be used with some practitioners. The best is to do your research around these fees, or get your advocate to do so.
In my personal experience when I saw a psychiatrist for therapy, I payed $250 for the first 9 sessions then I was able to use the Medicare Safety Net and the rest of the year was free.
Some other great websites for finding the right therapist for you:
Often people opt-in to the BAMHC because of finances. Let’s do a little math based on weekly therapy for a year, say 45 sessions in total, calculating holidays and little breaks. This is information only to give you an idea. You have to do your own research before you see your therapist.
Recommended hourly rate for psychologists: $250/ 50 minutes or more
Psychologist rebate under the Better Access for Mental Health:
$124.50/ 50 minutes or more.
$ 84.80/ 30-50 minutes.
Calculating with a rate of $200/50 minutes first 10 session you pay $75.50 / per session $750.50 the remaining 35 session $200/hour comes to $7000. So you would pay $7750/per year.
Social Workers charge similar to psychologists. You can find out more here. Information on the rebate they can provide is here.
Psychotherapist $150/ hour for a year would cost you: $6750.
Psychiatrist who offers therapy and can see you and provide treatment under Medicare would cost varying dependent on the status of your
There is an other scheme than the BAMHC is available in Sydney if you qualify, called PSS
I hope this information helped to give you a bit more insight about who can provide mental health service or therapy, and how you can find the most suitable person for you.
I will be updating this post as I collect more information. If you have any suggestions to include something, please let me know by leaving a comment below.
Korner, A., & McLean, L. (2017). Conversational model psychotherapy. Australasian Psychiatry, 25(3), 219-221.
Meares, R., & Jones, S. (2009). The role of analogical relatedness in personal integration or coherence. Contemp. Psychoanal., 45(4), 504-519.